摘要
目的分析插管全身麻醉(全麻)术后恶心呕吐(PONV)相关危险因素,为防治PONV提供临床依据。方法回顾性分析1185例行插管全麻患者病历资料,记录术后24 hPONV发生情况,按一般临床资料、术中手术及麻醉情况、术后处理进行统计分析,筛选PONV发生的相关危险因素。结果插管全麻恢复期PONV总发生率10.7%,PONV组127例,非PONV组1058例。多因素分析显示:女性[OR=4.355,95%CI(2.516,7.537)P<0.01]、接受过高等教育[OR=2.036,95%CI(1.309,3.167)P=0.002]、既往化疗史[OR=2.572,95%CI(1.634,4.049)P<0.01]是患者术后呕吐的独立危险因素;术中维持使用[OR=0.351,95%CI(0.206,0.597)P<0.01]以及术后使用右美托咪定[OR=0.366,95%CI(0.242,0.551)P<0.01]为保护性因素。ROC曲线下面积为0.776,模型预测准确率为89.2%。结论对于PONV高危患者,围术期应采取综合预防措施,术中及术后使用右美托咪啶有利于降低PONV。
Objective To analyze the concerned risk factors of postoperative nausea and vomiting(PONV) related to intubation general anesthesia,and to provide clinical basis for the prevention and cure of PONV. Methods A total of 1185 cases of intubation general anesthesia was retrospectively analyzed.The situations of PONV were recorded within 24 hours.By the statistical analysis of patients’ clinical data, intraoperative operation and anesthesia and post-operative treatment,the risk factors leading to PONV were filtered. Results Related to intubation general anesthesia and occurring in the recovery period,the total incidence of PONV is 10.7%.There are 127 PONV cases while the non-PONV ones account for 1058.Multifactor analysis implied that female [OR=4.355,95%CI(2.516,7.537)P<0.01], higher education background [OR=2.036,95%CI(1.309,3.167)P=0.002] and chemotherapy experience [OR=2.572,95%CI(1.634,4.049)P<0.01] are the independent risk factors leading to PONV.Intraoperative maintenance of using dexmedetomidine [OR=0.351,95%CI(0.206,0.597)P<0.01] and postoperative using dexmedetomidine [OR=0.366,95%CI(0.242,0.551)P<0.01] are the protective factors.The area under the ROC curve was 0.776 and the predicted accuracy rate of the model was 89.2%. Conclusion Comprehensive preventive measures should be taken for the high-risk patients suffering from PONV during the perioperative period.Dexmedetomidine is helpful for reducing PONV when it is used during and after the surgery.
作者
覃韬
黎阳
谢显龙
老启芳
黄英明
黄冰
QIN Tao;LI Yang;XIE Xianlong;LAO Qifang;HUANG Yingming;HUANG Bing(Department of Intensive CareUnit, The Affiliated Tumor Hospital of Guangxi Medical University,Nanning 5300219 China)
出处
《医药导报》
CAS
北大核心
2019年第11期1442-1445,共4页
Herald of Medicine
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研课题项目(Z2016488)
关键词
右美托咪定
全身麻醉
术后恶心呕吐
危险因素
Dexmedetomidine
General anesthesia
Nausea and vomiting,postoperative
Risk factor
